Frequently Asked Questions

The Iowa Health and Wellness Plan (IHAWP) is a way of getting Medicaid coverage for adults with low income. The Iowa Health and Wellness Plan covers almost all of the same services as other Medicaid programs. Also, if you have a disability or a serious medical condition, you may be determined Medically Exempt and be eligible for extra services.

To qualify for the Iowa Health and Wellness Plan, you must:

• Be under 65 years old
• Not be eligible for Medicare
• Be a U.S. citizen or meet specific noncitizen requirements, and
• Have income at or below 138% of the Federal Poverty Guidelines (FPG) or less ($1,800 per month or less for a person, $3,697 or less for a family of four).

Children and pregnant women can have higher family incomes and still qualify for Medicaid. There are no limits to how much money or other resources you can have.

Learn more about the Iowa Health and Wellness Plan.

It depends on how you qualify for Medicaid. The Iowa Health and Wellness Plan (IHAWP), Medicaid for pregnant women, and Healthy and Well Kids in Iowa (Hawki) have no resource limit. However, some people with disabilities and seniors may qualify for disability-based Medicaid or Medicaid for Employed People with Disabilities (MEPD), which do have resource limits.

If you need more help in understanding Medicaid, you can:

• Talk to an Iowa health insurance navigator. You can call them at 1-877-474-6284 or make an appointment online.
• Visit or call your local Health and Human Services (HHS) office.
• Get local help from HealthCare.gov.
• If you have a disability, talk to a benefits planner to learn more about health programs for people with disabilities.

There are different ways to apply for Medicaid:

• Online using the Iowa HHS Benefits Portal. The Iowa HHS Benefits Portal lets you apply for other programs, like the Supplemental Nutrition Assistance Program (SNAP) or the Family Investment Program (FIP), at the same time.
• Online using HealthCare.gov, an online one-stop shop where you can learn about your public and private coverage options.
• In person at your local Health and Human Services (HHS) office.
• By filling out a paper application and bringing it in person to your local Health and Human Services (HHS) office or faxing or mailing it to the address listed on the form.
• By calling the Health and Human Services Contact Center at 1-855-889-7985.

Note: If you get Supplemental Security Income (SSI) or used to and now are on SSI 1619(b), you automatically get Medicaid coverage. You do not need to apply for Medicaid

No, Medicaid is also available to people who do not have disabilities. Adults under 65 may qualify for Medicaid through the Iowa Health and Wellness Plan (IHAWP) if their income is at or below 138% of the Federal Poverty Guidelines (FPG) ($1,800 per month or less for a person, $3,697 or less for a family of four). Children under 19 and pregnant women can have higher family incomes.

There are additional ways to get Medicaid if you have a disability or are a senior. When you apply for Medicaid, the person reviewing your application will figure out which type of Medicaid is best for you.

Note: Some people who do not qualify for most Medicaid benefits, such as undocumented immigrants, may qualify for coverage in emergencies only.

You and your family can usually get Medicaid through the Iowa Health and Wellness Plan (IHAWP) if your family’s income is at or below 138% of the Federal Poverty Guidelines (FPG) ($1,800 per month for an individual, $3,697 for a family of four).

Children under 19 can get Healthy and Well Kids in Iowa (Hawki) if their family's income is 307% of FPG or less ($8,225 per month or less for a family of four). Pregnant women can get Medicaid if their family's income is 220% of FPG or less. (For the purposes of calculating a pregnant woman’s family income, the unborn baby is counted as a family member.)

You may see the income limit for the Iowa Health and Wellness Plan listed as 133% of FPG in some places. However, when Medicaid counts your income, they’ll knock 5% of FPG off your income if you make more than 133% of FPG. That's why we show the limit as 138% of FPG, because it more accurately shows how much you could make and still get Medicaid.

The Iowa Health and Wellness Plan counts most types of earned and unearned income you have. However, some income is not counted, including Supplemental Security Income (SSI) benefits and some contributions to retirement accounts. Learn more about what types of income affect Iowa Health and Wellness Plan eligibility.

Note: The income limits may be different if you have a disability. Read DB101’s article about disability-based Medicaid.

Try the tool below. If your income is at or below 138% of FPG, you may qualify for the Iowa Health and Wellness Plan.

Health Coverage Income Limits for Your Family

Your family size:	123456789101112
Income limits for your family:
	$15,650
	$5,500
	$15,650
	$5,500
	400
	307
Iowa Health and Wellness Plan (138% FPG)
Healthy and Well Kids in Iowa (Hawki) (307% FPG)
Subsidized private plans, reduced fees (250% FPG)
Subsidized private plans (400% FPG)
If your family's income is at or below the limit for a program, you may qualify if you meet other program rules. Notes: Some types of income do not count against these limits, including SSI benefits. Different programs sometimes use slightly different numbers for the Federal Poverty Guidelines (FPG). Disability-based Medicaid eligibility is not included here. For private plans with subsidies, your monthly premium amount depends on your income.

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Yes, if your family’s income is low enough for you to qualify for Medicaid, you may sign up for Medicaid even if your job offers insurance.

If you get Medicaid and also want to enroll in your employer's health plan, you may qualify for Iowa's Health Insurance Premium Payment (HIPP) program. If you have HIPP, Medicaid pays your plan's premium and the other costs of getting medical care, like the copayments and the deductible. You are not enrolled in a Medicaid managed care plan; instead, your employer's health plan is your main health coverage.

You must apply separately for HIPP after you are approved for Medicaid. Learn more about HIPP and how to apply.

You must be a U.S. citizen or meet specific noncitizen requirements to be eligible for Medicaid:

• Immigrants who have been lawfully present for five years or longer and some other noncitizens who meet specific noncitizen requirements qualify for the same programs that U.S. citizens can get, including Medicaid.
• Most immigrants who have been lawfully present for less than five years do not qualify for Medicaid. However, they may qualify to get private coverage subsidized by the government through HealthCare.gov.
• Undocumented immigrants do not qualify for Medicaid, but they may qualify for Emergency Medicaid. To learn more about this, contact your local Health and Human Services (HHS) office.

In most cases, it does not matter how you qualify for Medicaid, because the actual medical coverage you get from Medicaid will be the same. Generally speaking, the big difference is that people with disabilities get extra ways to qualify and if you have a disability and start working, you can earn more while still getting Medicaid coverage.

DB101 has three articles about different ways to get Medicaid:

• The Iowa Health and Wellness Plan (IHAWP) article explains the most common way to qualify, which does not require you to have a disability.
• The disability-based Medicaid article explains common ways for people with disabilities who have low incomes to qualify.
• The Medicaid for Employed People with Disabilities (MEPD) article explains a way that people with disabilities who work can get Medicaid coverage by paying a premium.

If you are not sure how you qualified for Medicaid, you can ask your local Health and Human Services (HHS) office.

If you can't get affordable employer-sponsored coverage, Medicaid, or Medicare and your family's income is at or below 400% of the Federal Poverty Guidelines (FPG) ($62,600 for an individual; $128,600 for a family of four), you may be able to get tax credits to help pay the premiums for individual coverage on HealthCare.gov. Note: From 2021 through 2025, there was no income limit for getting subsidies that help pay individual coverage premiums. However, a 400% of FPG income limit is set to return for 2026. DB101 will be updated if there are any changes.

You can read more about this option in DB101’s article about Buying Coverage on HealthCare.gov.

The Iowa HHS Benefits Portal is the easiest way to apply for Medicaid if you think you might qualify. The Iowa HHS Benefits Portal also lets you apply for other benefits, like the Supplemental Nutrition Assistance Program (SNAP), at the same time.

HealthCare.gov is a good option if you don’t think you will qualify for Medicaid, because it will also check and see if you can get private coverage with subsidies. If HealthCare.gov sees that you are eligible for Medicaid, your local Health and Human Services (HHS) office will contact you about enrolling.

The bottom line: Both systems will help you find the benefits you need. The big difference is that, depending on your situation, one might be a bit faster than the other.